Provider Demographics
NPI:1942393137
Name:NUSAIR, MAEN (MD)
Entity Type:Individual
Prefix:
First Name:MAEN
Middle Name:
Last Name:NUSAIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MAEIN
Other - Middle Name:
Other - Last Name:NUSAIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:880 W CENTRAL RD STE 7100
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2379
Mailing Address - Country:US
Mailing Address - Phone:847-618-2500
Mailing Address - Fax:847-392-7834
Practice Address - Street 1:880 W CENTRAL RD STE 7100
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2379
Practice Address - Country:US
Practice Address - Phone:847-618-2500
Practice Address - Fax:847-253-8474
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009017500207R00000X
IL036132521207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease